Pediatric Acute Pain Management in a Mediterranean Emergency Department

Abstract

Background: In 2012, the World Health Organization considered inadequate pediatric pain management a concerning public health issue. With little research done on this topic, it is essential to understand the attitudes and knowledge of medical care providers regarding acute pain management Methods: In this prospective cross-sectional descriptive study, healthcare providers caring for children less than 18 years of age completed a survey assessing their knowledge of adequate pediatric pain management. The survey was based on a validated questionnaire. This study took place in a Lebanese urban tertiary care center emergency department between July and September 2018. Results: None of the 20 questions were answered correctly by all participants. Only a third of the questions (7/21) were answered correctly by less than 50% participants. The most incorrectly answered questions were about the pharmacology and pharmacodynamics of the medications. We found that most providers would treat a potentially painful procedure like a lumbar puncture with a slow acting topical anesthesia (75.9%) or a manipulation of a suspected fracture with an oral medication (58.2%). When stratified by position (Attending, Resident, RN) the attendings were significantly more likely (88.9%; p=0.03) to treat the pain first. Similarly, stratification by specialty showed that EM providers are significantly more likely than other specialties (91.8%; p=0.001) to treat the pain before further evaluation. Conclusion: Findings from this study highlight the need to educate better the healthcare providers treating pediatric pain in the ED. Continuous medical education and training programs should highlight proper pediatric pain management. © 2022, American University of Beirut. All rights reserved.